Provider Demographics
NPI:1184196495
Name:ADAMS, BOBBIE LEE
Entity Type:Individual
Prefix:MS
First Name:BOBBIE
Middle Name:LEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BOBBIE
Other - Middle Name:LEE
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6216 S LEWIS AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-1077
Mailing Address - Country:US
Mailing Address - Phone:918-960-7852
Mailing Address - Fax:
Practice Address - Street 1:6216 S LEWIS AVE STE 180
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1077
Practice Address - Country:US
Practice Address - Phone:918-960-7852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator